Patient education: Uterine cancer (The Basics)

What is uterine cancer? — 

This is when normal cells in the uterus change into abnormal cells and grow out of control. The uterus is the part of the body that holds a baby during pregnancy. It has a thin inner lining layer (called the "endometrial lining") and a thick outer layer (figure 1). There are different types of uterine cancer, but most start in cells in the thin inner lining.

Uterine cancer can occur at any age but is much more common in people who have gone through menopause. (This is when you stop having menstrual periods.)

What are the symptoms of uterine cancer? — 

The most common symptom is abnormal vaginal bleeding. This includes:

●Bleeding between menstrual cycles (when you are not having your period)

●Heavy menstrual bleeding

●Any vaginal bleeding if you have been through menopause

These symptoms can also be caused by conditions that are not cancer. But if you have these symptoms, tell your doctor or nurse.

Is there a test for uterine cancer? — 

Yes. If you have abnormal vaginal bleeding, your doctor or nurse might order a test called a "biopsy" to check for uterine cancer. During a biopsy, the doctor takes a small sample of tissue from the uterine lining. Another doctor looks at the sample under a microscope to see if there is cancer.

Your doctor might also do an imaging test called an ultrasound. This uses sound waves to create pictures of the inside of the uterus.

Depending on your situation, your doctor might recommend other tests, too.

What is cancer staging? — 

This is a way to find out how far the cancer has spread.

The right treatment for you depends a lot on the stage of your cancer and how fast it is growing. Your treatment also depends on your age and other medical problems.

What if I want to get pregnant in the future? — 

If you have not yet gone through menopause and want to get pregnant in the future, talk with your doctor before starting treatment. This is because many treatments for uterine cancer make it so you cannot get pregnant later.

Your doctor will talk to you about your situation and your options. For example, most people with uterine cancer have surgery. But sometimes, it is possible to delay surgery and try a different treatment first. If you do need surgery, your doctor can talk to you about other options for growing your family in the future.

How is uterine cancer treated? — 

The main treatment is surgery to remove the uterus, the ovaries, and the tubes connecting the ovaries to the uterus (fallopian tubes). Removing the uterus with surgery is called a "hysterectomy" (figure 2 and figure 3). During surgery, the doctor will also check the area and organs around the uterus to see if the cancer has spread. They might remove other organs that look abnormal.

Some people do not need more treatment after surgery if the surgery removed the cancer. But other people might need more treatment with 1 or both of these:

●Chemotherapy – These are for medicines that kill cancer cells or stop them from growing.

●Radiation therapy – This kills cancer cells. Radiation can be given from a machine that is outside the body. Or a doctor can put a source of radiation directly into the vagina.

Some people can first be treated with hormone medicines called "progestins" instead of surgery. But this is done only in special situations.

What happens after treatment? — 

You will be checked regularly to see if the cancer comes back. Your doctor or nurse will ask about your symptoms and do an exam. Follow-up tests sometimes include blood tests and imaging tests such CT scans. Imaging tests create pictures of the inside of the body.

Watch for symptoms of abnormal vaginal bleeding, belly pain, or a cough that won't go away. Tell your doctor or nurse if you have these symptoms. They could mean your cancer has come back.

What happens if the cancer comes back or spreads? — 

You might have more surgery, radiation therapy, or chemotherapy.

What else should I do? — 

Follow all your doctor's instructions about visits and tests. It's also important to talk to your doctor about any side effects or problems you have during treatment.

Getting treated for uterine cancer involves making many choices, such as what treatment to have. Always tell your doctors and nurses how you feel about a treatment.

Any time you are offered a treatment, ask:

●What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?

●What are the downsides of this treatment?

●Are there other options besides this treatment?

●What happens if I do not have this treatment?

More on this topic

Patient education: Menopause (The Basics)
Patient education: Heavy periods (The Basics)
Patient education: Endometrial biopsy (The Basics)
Patient education: Preserving fertility after cancer treatment in women (The Basics)
Patient education: Hysterectomy (The Basics)
Patient education: Chemotherapy (The Basics)
Patient education: External beam radiation therapy (The Basics)

Patient education: Endometrial cancer diagnosis, staging, and surgical treatment (Beyond the Basics)
Patient education: Endometrial cancer treatment after surgery (Beyond the Basics)
Patient education: Menopause (Beyond the Basics)
Patient education: Abnormal uterine bleeding (Beyond the Basics)
Patient education: Abdominal hysterectomy (Beyond the Basics)
Patient education: Vaginal hysterectomy (Beyond the Basics)